Baked milk: Identifying patients who can tolerate baked milk
Elizabeth, a 5-year-old with a milk allergy, visits her healthcare provider for her annual check-up. Since 75 percent of children with cow’s milk allergy can tolerate baked foods containing milk,1,2 Elizabeth's healthcare provider suggested she should be tested with milk and to include milk component testing.
Elizabeth is allergic to milk, but may now be able to eat foods containing baked milk without an allergic reaction.
Patient History
Family History
- None
Elizabeth's Personal History
- Diagnosed with eczema at her six-month check up.
- Gastrointestinal distress, vomiting, and eczema worsening after drinking milk at age 3.
Elizabeth's ImmunoCAPTM Test Results
These results together with this patient's case history and symptoms, help confirm the diagnosis.
Test |
Type |
Elizabeth's Results |
Milk |
Whole Allergen |
2.13 |
Bos d 4 (α-lactalbumin) |
Allergen Component |
1.22 |
Bos d 5 (β-lactoglobulin) |
Allergen Component |
<.10 |
Bos d 8 (casein) |
Allergen Component |
<.10 |
Differential Diagnosis
Elizabeth is sensitized to α-lactalbumin proteins. Risk for reaction may be reduced when milk is thoroughly heated. She is not sensitized to casein proteins associated with severe reactions.1,2
HEALTHCARE PROVIDER MANAGEMENT PLAN
- Elizabeth's healthcare provider refers her to an allergy specialist for an oral food challenge with baked milk.
- The allergy specialist performs an oral baked milk challenge in the clinic, which Elizabeth passes without any symptoms.
- The allergy specialist recommends that Elizabeth undergo retesting in about two years
FOLLOW UP
- Elizabeth is seen by her healthcare provider two years later. Baked milk is now part of Elizabeth’s diet and she is doing well.
The people, places, and events depicted in these case studies and photographs do not represent actual patients, nor are they affiliated in any way with Thermo Fisher Scientific.
- Nowak-Wegrzyn A, et al. Tolerance to extensively heated milk in children with cow’s milk allergy. J Allergy Clin Immunol. 2008;122:342-7.
- Caubet JC, et al. Utility of casein-specific IgE levels in predicting reactivity to baked milk. J Allergy Clin Immunol. 2013;131:222-4.
